IVF Diary Part 3: The protocol

This is Part 3 of the IVF Diary series. I’ll be keeping a diary of all important IVF days, starting from when we first chose to undergo infertility treatment in Prague. Click here to read all other IVF diary posts.

I talked about our initial consult in the previous post where I laid out that the doctor mentioned I should expect my protocol in about a week. I know they’re in a different time zone over in the Czech Republic, but about a week should be about a week, give or take a 6-hour difference 😉

It took nearly three weeks before I received my protocol. I had to practice my ability to develop a bit of patience which took wayyyy longer than I expected. Oh the irony…

Blown Deadlines

I emailed twice and tried to be on my best behavior when asking where the hell my protocol was.

It went something like this,

Dear IVF coordinator, it’s been 10 days since our last conversation where the doctor mentioned I’d be receiving my protocol in about a week. Is there anything you need from me at this point to move forward? Please let me know.

Which was a carefully edited draft of my previous version, which went something like this;

They replied back saying to just sit tight and that the doctor was working on it. I’m sure they do their own share of careful edits to emails before they respond to one of the hundreds of annoying impatient patients that keep bugging all the time.

I still hadn’t received anything another week after that, so I sent them a friendly nudge to hurry the hell up. A few days later, I got a new IVF coordinator (I swear this is standard protocol and didn’t have anything to do with my emails) who was kind enough to attach that mythical protocol.

The coordinator casually mentioned that she takes care of approximately 90 patients and that women who are currently on treatment are of higher priority than those who are just bitching about their protocol being a couple of days late.

I bet she said it more elegantly, but that was the essence of it. I get it, I really do. Dealing with impatient women is one thing, but dealing with impatient women on a high dose of hormones is something else altogether! Besides, I’m really not that impatient (edit by Mr. Frugalcrib: Hah! Not really that great of a liar either!).

The protocol ended up being just a short 1-page document with a calendar of day 1 through 30 and which drugs to take during those respective days. It also listed when I’d be expected to come in for my ultrasounds with a footnote that those things may change depending on how well I respond to the meds.

Ovulation induction will be on day 13 (aka the “Trigger Shot”) and egg retrieval will follow about 36 hours later with embryo transfer at day 20. At least, that’s how it shouldbe going. Hah! I pity the fool who expects any IVF treatment to go according to plan. Isn’t that something Mr. T. famously said?

Ah, there we go, he did say just that!

Rebelling Against Doctor’s Orders

I digress. The most important part of the protocol was the prescription for the medication I’d be taking. Being the scientists that Mr. Frugalcrib and I are, we researched the hell out of all the drugs and doses mentioned.

There were two adjuvant therapies listed that I didn’t really agree with. Clinics all over the world try to improve pregnancy rates by adding on certain meds that are supposed to aid with things like implantation and other stuff.

We couldn’t find any scientific studies overwhelmingly in favor of using these two adjuvants, and with this being my first IVF cycle, I kinda just want to see how my body responds with as few extras as possible. More does not always equal better.

I might have been more open to trying them if this was my third or fourth cycle, or if the science pointed in favor of using ‘em. Anyway, I emailed my coordinator with my concerns and the doctor agreed I’d be fine skipping those.

Protocol Timeline

I’ll have my first ultrasound about a week before I start my new cycle. This is what our clinic calls the “pre-stimulation scan” which (as the name accurately suggests) describes when the scan is supposed to be scheduled for. It’s to check and make sure there aren’t any problematic cysts and polyps that may throw a wrench in the whole IVF procedure. I’ll be doing the scan over here in the US, and will send the results to our clinic in Prague.

Then, on the second day of my cycle, I’ll start with my daily evening injections of Gonal-F, the drug causing superovulation. I’ll continue that right up until the day of the trigger shot, which matures the eggs and gets them ready to be harvested.

Before that happens though, I’ll be starting Cetrotide injections from day 7 to 12 to prevent any naturally occurring LH surges that cause you to ovulate before the retrieval. And if me and my embryos are lucky enough to make it all the way to transfer day, I’ll also be starting progesterone suppositories (fancy way of saying those pills are the ones you actually shove right up inside you) for two weeks or until the eighth week of pregnancy in case I would end up pregnant.

This is what my timeline looks like as of now:

But as you’ve seen from this post here, there’s still an average of 34.9% chance that I won’t even make it to transfer day, so let’s take it one step at a time. Because, you know… I pity the fool who expects any IVF treatment to go according to plan!